Jeffrey Shoub, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

222435 Issued in NY

Practice address

339 Hicks St
Brooklyn, NY 11201-5509

Phone

(718) 780-1961

NPI assigned

Jan 19, 2007

Last updated

Feb 11, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Hahnemann University College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Delphi Healthcare PLLCGroup PAC ID 9537229661, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carthage Area Hospital, Inc Hospital, Ogdensburg, NY, CCN 331324

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Delphi Healthcare PLLC

  • Emergency Medicine Physician
  • Rochester, NY
  • NPI 1003075029
  Medicare reassignment Care Compare group NPD
• Alice Hyde Medical Center

  • Critical Access Hospital
  • Malone, NY
  • NPI 1114954682
  Medicare reassignment NPD
• Delphi Hospitalist Services LLC

  • Hospitalist Physician
  • Rochester, NY
  • NPI 1922270420
  Medicare reassignment NPD
• Emergency Physician Services of New York, P.C.

  • Emergency Medicine Physician
  • Poughkeepsie, NY
  • NPI 1093759847
  Medicare reassignment NPD
• Island Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Far Rockaway, NY
  • NPI 1639160385
  Medicare reassignment NPD
• Massena Hospital Inc

  • Critical Access Hospital
  • Massena, NY
  • NPI 1972604460
  Medicare reassignment
• Alice Hyde Medical Center

  • General Practice Physician
  • Malone, NY
  • NPI 1568735660
  NPD
• Massena Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Massena, NY
  • NPI 1619756640
  NPD
• Medical Services of Suffolk County PC

  • Emergency Medicine Physician
  • Philadelphia, PA
  • NPI 1811235724
  NPD
• Alice Hyde Medical Center

  • Skilled Nursing Facility
  • Malone, NY
  • NPI 1356441349
  NPD (past)
• Lich Faculty Practice

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1104018902
  NPD (past)
• Long Island College Hospital

  dba Emergency physicians at LICH

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1912091828
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carthage Area Hospital Inc

  dba Claxton-Hepburn Medical Campus

  • Critical Access Hospital
  • Ogdensburg, NY
  • NPI 1669236261
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1194878793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 AIRPORT EXE PARK",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "10954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 HICKS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015509",
            "telephone_number": "718-780-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUB",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "222435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02407454",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3007132",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Shostak, MD
• Yana Shostak, MD
• Molly Shotts, PA
• Megan Shotwell
• Jeanne Marie Shotzbarger, RN
• Ivan Igor Shoukhardin, PHARMD
• Meredith Anne Shouse, LCSW
• Lyubov Shovkun, RN
• Jody Showell
• Zahra Showkatian, DDS

• Emergency Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.